Hello! I am a new hospice educator with a vascular access background. Im with a hospice that sees patients in-home and in our hospice facilities. Our medical director would like our nurses to be able to place PIVs now to provide IV hydration when clinically indicated. I am currently working on the policy and protocol for this. I expressed my concern for patient safety since most of our nurses are not currently proficient in placing IVs. I believe training a small group of our nurses to be able to perform this skill and maintain competence would be safest. Can anyone recommend resources to pull from when working on this policy? I have been using the INS 2016 SOP mainly.
I asked about obtaining visualization tools, such as a vein light or ultrasound. Management is open to a vein light depending on cost, but were not open to obtaining an ultrasound. This is were I am feeling very torn. During my time as a vascular access nurse, I became very passionate about ultrasound-guided PIVs. I saw how beneficial it was to be able to provide this service to patients. My first time insertion success rate was 96% with ultrasound, which was much higher than inserting without ultrasound. Since comfort is our goal, I feel using ultrasound would be essential to prevent undue pain and complications. I also feel that we may have a high population of patients with difficult venous access due to caring for end-of-life patients. I know more training and practice is required to be able to be proficient at placing UGPIVs, and I am willing to provide that.
Am I way off base in wanting to change their minds about being able to place UGPIVs? Are there any recent studies supporting always placing ultrasound guided PIVs?